MRS. BROOKE B. TEAL (NPI# 1427093731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427093731 |
| Entity Type | Individual |
| Full Name | MRS. BROOKE B. TEAL |
| Credential | PA-C |
| Practice Address |
1020 J L White Dr Ste 160 Jasper GA 30143-4910 |
| Mailing Address |
531 Roselane St Nw Ste 710 Marietta GA 30060-6975 |
| Practice Telephone | 7066920603 |
| Practice Fax Number | 6785817109 |
| Mailing Telephone | 6783313297 |
| Mailing Fax Number | 6785817187 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2019-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
004814 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 683984257A | 05 | |
| NPI NUMBER | 1427093731 | 01 | |
| GA | 683984257C | 05 | |
| GA | 683984257B | 05 |
| Street Address |
1020 J L WHITE DR STE 160 |
| City | JASPER |
| State | GA |
| Zip Code | 30143-4910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447249156 | Curtis R Miles | Internal Medicine | 1020 J L White Dr Ste 160, Jasper, GA 30143-4910 | 2005-10-14 |
| 1851566202 | Ghada Mahmood Kunter | Internal Medicine | 1020 J L White Dr Ste 160, Jasper, GA 30143-4910 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1598363434 | Amanda J Griggs | Massage Therapist | 54 Wolfscratch Village, Jasper, GA 30143 | 2020-10-13 |
| 1801397724 | Jema Day | Nurse Practitioner | 620 J L White Dr Ste 140, Jasper, GA 30143 | 2018-02-26 |
| 1023467545 | North Georgia Personal Care LLC | Home Health | 501 North Main St., Suite B, Jasper, GA 30143 | 2016-06-06 |
| 1871979641 | Sj & J Spine and Pain Group Holding LLC | Pain Medicine | 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 | 2015-08-04 |
| 1801294293 | Highland Recovery Center | Community/Behavioral Health | 323 Roland Road, Jasper, GA 30143 | 2014-12-17 |
| 1770905861 | Leslie Rhea Hanagan | Speech-Language Pathologist | 22 Dogwood Lane, Jaser, GA 30143 | 2014-01-09 |
| 1669800660 | Pickens County Chiropractic | Chiropractor | 95 North Main Street, Jasper, GA 30143 | 2013-10-29 |
| 1407139264 | Rocky Mountain Holdings LLC | Ambulance | 70 Airport Business Court, Jasper, GA 30143 | 2011-09-27 |
| 1851681415 | Richard J Vandam | Internal Medicine | 1266 Highway 515, Piedmont Mountainside Hospital, Jasper, GA 30143 | 2011-04-15 |
| Find all providers in zip 30143 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760831655 | Erica Weddington | Physician Assistant | 150 Interstate South Dr Ste 100, Jasper, GA 30143-6252 | 2016-06-10 |
| 1609843457 | Marvin Langford | Physician Assistant | 175 Samaritan Dr, Jasper, GA 30143-1964 | 2006-03-01 |
| 1811993041 | Janice L West | Physician Assistant | 1020 J L White Dr, Suite 160, Jasper, GA 30143-4908 | 2005-06-22 |
| 1194386573 | Melanie Martin | Physician Assistant | 1025 1st Ave W, Jasper, IN 47546-3217 | 2019-06-26 |
| 1851899322 | Taylor Anne Countiss | Physician Assistant | 3400 Highway 78 E, Jasper, AL 35501-8956 | 2018-01-30 |
| 1598116790 | Erin Flanagan | Physician Assistant | 1266 Highway 515 S, Jasper, GA 30143-4872 | 2016-06-29 |
| 1386885069 | Jason Fleury | Physician Assistant | 220 J L White Dr, Suite 100, Jasper, GA 30143-4893 | 2009-03-10 |
| 1972780609 | Lassiter Emergency Group LLC | Physician Assistant | 1000 Highway 28, Jasper, TN 37347-3638 | 2008-01-24 |
| 1346442746 | Jasper Emergency Medicine Associates Pa | Physician Assistant | 1275 Marvin Hancock Dr, Jasper, TX 75951-4935 | 2007-06-05 |
| 1073670469 | Kehinde Adekoyejo Akinfenwa | Physician Assistant | 1006 Dickerson Dr, Jasper, TX 75951-5111 | 2007-01-03 |
| Find all providers in JASPER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.